ABSTRACT Problem Statement: The universal coverage policy (UCP) and 30 Baht Scheme was launched in Thailand in February, 2001. Since then, the National.

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ABSTRACT Problem Statement: The universal coverage policy (UCP) and 30 Baht Scheme was launched in Thailand in February, 2001. Since then, the National Drug Policy in Thailand has limited the number of drugs available in community hospitals and has permitted use of traditional medicines for treatment. Some patients were prescribed traditional medicines to lower the cost of treatment as a substitute for modern medicine. Objectives: To assess trends in haemorrhoids prescriptions, comparing the use of traditional and modern medicines in a community hospital before and after the UCP, and to compare the cost of haemorrhoids treatment before and after policy implementation. The traditional drug prescribed was Petch Sang Kart. The modern alternative was Proctosedyl. Design: Retrospective time series study. Methods: All haemorrhoids prescriptions from October 2000 to January 2003 were collected. The trends of prescriptions and cost of traditional and modern medicines for treatment of haemorrhoids were compared before and after the UCP was implemented. Outcome Measures: The percentage of patients who were given traditional medicines and/or modern medicine for haemorrhoids per month; the average number of tablets of traditional or modern medicine used per person per month; the cost of treatment per prescription per person per month; and the ratio between the number of traditional and modern medicines prescribed per person per month. Results: A total of 256 prescriptions covering the study period were analyzed. All patients received traditional medicines, while about half of them received both traditional and modern medicine. The average cost of prescriptions per person per month decreased (24.0 versus 7.1 baht, p = 0.001). Likewise, the number of traditional medicine prescribed per visit per month decreased (traditional = 8.0 versus 3.3 tablets, p =0.004). However, the number of modern medicine prescribed per visit per month and the ratio between traditional and modern medicine remained stable (3.4 versus 2.0 tablets, p = 0.124, ratio=.40 versus .86 , p= .052). Conclusions: The Universal Coverage Policy of Thailand resulted in a reduction in provision of traditional medicine, the ratio of medications, and the cost of prescriptions. The effectiveness of treatment between the two periods are being analyzed.

BACKGROUND (1) The Universal Coverage Policy (UCP) and 30 Baht Scheme was launched in Thailand in 2001. Under the Scheme, people pay 30 Baht for each visit or admission. Since then, the National Drug Policy has limited the number of drugs available in community hospitals and has permitted use of traditional medicine for treatment. Some patients were prescribed traditional medicine to lower the cost of treatment as substitute for modern medicine.

BACKGROUND (2) Many traditional medicines in Thailand are in use without clinical trial against modern drugs. This is the first of a number of studies to be undertaken to make comparison traditional and modern drug. The traditional drug prescribed was Petch Sang Kart (Cissus Quadrangularis Linn). The modern alternative was Proctosedyl.

OBJECTIVES To assess trends in haemorrhoids prescriptions, comparing the use of traditional and modern medicines in a community hospital before and after the UCP -To compare the cost of haemorrhoids treatment before and after policy implementation

METHOD (1) Study Design: Retrospective time series study Study Area: A community hospital in Chiang Mai The haemorrhoids prescriptions from October 2000 to January 2003 were collected. The level and trends of prescriptions and cost of traditional and modern medicines for treatment of haemorrhoids were compared before and after the implementation of 30 Baht Scheme

Measurement The percentage of patients who were given traditional medicines and/or modern medicine for haemorrhoids per month The average number of tablets of traditional or modern medicine used per person per month The cost of treatment per prescription per person per month The ratio between the number of traditional and modern medicines prescribed per person per month.

RESULTS (1) Overall of 256 prescriptions were analyze, two-third of prescriptions were female. The mean age of patients was 45.74 years with S.D. =15.12 and range 10-81 years. All patients were prescribed Petch Sang Kart with half of them received both Petch Sang Kart and Proctosedyl.

RESULT (2) Figure1: Month (Baht/Tablet) Month Figure1: PSK: The average tablet of PSK per visit per month Proc: The average tablet of Proctosedyl per visit per month Cost: The cost of treatment per visit per month Ratio: The ratio of tablet PSK/Proc per visit per month Remark: PSK= Petch Sang Kart (Cissus Quadrangularis)

RESULTS (3) The average cost of prescriptions per person per month decreased (24.0 versus 7.1 Baht, p = 0.001). The number of traditional medicine prescribed per visit per month decreased (traditional = 8.0 versus 3.3 tablets, p =0.004). The number of modern medicine prescribed per visit per month and the ratio between traditional and modern medicine remained stable (3.4 versus 2.0 tablets, p = 0.124, ratio=.40 versus .86 , p= .052).

CONCLUSIONS The retrospective study of heamorrhoids treatment in a community hospital found that the Universal Coverage Policy of Thailand resulted in a reduction in provision of traditional medicine, the ratio of medications, and the cost of prescriptions.